Avoid Metoprolol IV push in patients with severe bradycardia (heart rate below 60 bpm), second – or third-degree heart block (unless a pacemaker is in place), cardiogenic shock, or severe hypotension.
Severe Heart Conditions
- Proceed with caution in patients with sick sinus syndrome, sinoatrial block, or left ventricular dysfunction. Closely monitor heart rate and blood pressure. Consider alternative treatment options if the patient exhibits signs of worsening heart failure.
Respiratory Issues
Use Metoprolol IV push cautiously in patients with asthma or chronic obstructive pulmonary disease (COPD). Bronchospasm may occur; monitor respiratory status vigilantly.
Other Precautions
Administer Metoprolol IV push slowly over at least 2 minutes to minimize adverse events. Continuous cardiac monitoring is recommended during and after IV administration. Monitor for hypotension, bradycardia, and other adverse effects. Adjust dosage based on individual patient response and clinical status. Regularly reassess hemodynamic parameters. Use with caution in patients with peripheral vascular disease, as Metoprolol can exacerbate symptoms. Inform patients of potential side effects such as dizziness, fatigue, and nausea. Advise them to avoid driving or operating machinery if experiencing these symptoms.
Drug Interactions
Be aware of potential interactions with other medications, including calcium channel blockers, other beta-blockers, and certain antiarrhythmic drugs. Consult drug interaction databases as needed.
Special Populations
- Adjust dosing carefully in patients with impaired hepatic or renal function. Use caution in elderly patients, and consider lower starting doses.
